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This past January there was an article entitled "Website May Spark Change in Medical Economics" that introduced a new company called Carol.com. This article written by Chen May Yee, appeared in the Star Tribune, and compared Carol.com's ambitions to that of Travelocity with expectations of it impacting healthcare, like Travelocity did travel.

What is Carol.com and how exactly is it going to bring about change? The idea behind Carol.com is like that of WebMD, but instead of providing your medical diagnosis, it provides practical solutions as to where to go and who to see. For example, if you have ankle pain you would click on the matching body part on the human diagram and options will pop up for healthcare in the area. The first option might be for doctors at Sports and Orthopaedic Specialists, who will check out your ankle, review your medical history and recommend treatment, for $199. The second option might list TRIA Orthopaedic Center, advertising a similar package for $213 - but boasting that they are the team doctors for the Vikings and Timberwolves. You can also read patient comments, user reviews, and even find out about health insurance coordination.

The idea is to compare quality and price, so that consumers can shop their healthcare, eventually creating an open medical marketplace, which will drive down price and increase quality. Carol.com is gathering information so that consumers can do their own research before they buy. Yee states that:

"if the Carol site takes off, supporters say, Carol and the copycats it inspires could profoundly affect how Americans buy health care. It's success depends on whether hospitals and clinics embrace the radical notion of bundling and pricing care with consumers in mind, not insurers, and make it all easy to compare."

Paul Ginsburg, president of the Center for Studying Health System Change in Washington said:

"We need to move in this direction. If Carol succeeds in the Twin Cities, it should work in a lot of other places."

It is clear that some providers are more willing to invest in the idea, than others. According to Yee:

HealthPartners put 100 employees to work describing and pricing more than 60 packages on Carol, while the Mayo Clinic has posted just one -- for pregnancy counseling. The Twin Cities' two biggest chains, Allina and Fairview, have yet to join."

Carol.com is working hard to get their product in front of the public, but it's not the only effort to guide patients through healthcare decisions. Blue Cross Blue Shield of Minnesota last year launched HealthcareScoop.com for patients to post reviews of doctors and hospitals. Medica offered Mainstreetmedica.com, listing price ranges for procedures. Additionally, State law now compels insurers and hospitals to give price estimates if asked, so inevitably there are more of these sites to come.

So how did we get to the point of shopping for healthcare online? In the past, healthcare consumers only cared about monthly premiums and office visit copays. We pumped all our money into premium, so we didn't have to think about how we were covered. In doing so, we turned a blind eye to cost and it created disengaged consumers as well as reckless spending. This point rings true when hearing our author remind us that "medical costs are now consuming a whopping sixteen percent of our economy -- far more than in other developed nations".

The days of office visit copays are shifting to plans that put spending decisions back in the employee's court. This shift is likely to continue no matter who moves into the White House next January as the top Republican presidential candidate supports expanding health savings accounts and the leading Democratic candidates are focused more on expanding coverage for the uninsured, and call for better consumer information on price and quality. We've been talking about consumer engagement for years and now thanks to websites like Carol.com, consumers have been given the tools to make consumer engagement a reality.

Yee, Chen May; Website May Spark Change in Medical Economics Star Tribune, January 28th 2008.

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